Possibilities of Minimally Invasive Technologies in the Surgical Treatment of Myrizzi Syndrome Type I

Resume. Aim: Optimization of minimally invasive technologies in the surgical treatment of Mirizzi Syndrome Type I. Materials and Methods: The study is based on the treatment experience of 103 patients with Mirizzi Syndrome Type I. Patients underwent comprehensive examination, including clinical and laboratory methods, ultrasound examination, fibrogastroduodenoscopy, and, when indicated, endoscopic retrograde cholangiography and intraoperative cholangiography. Results and Discussion: Ultrasound examination allowed suspicion of Mirizzi Syndrome Type I in 72 (69.9%) patients. Laparoscopic cholecystectomy was successful in 69 (93.2%) patients with Mirizzi Syndrome Type I A. In cases of Mirizzi Syndrome Type I B (stage “common wall”), subtotal laparoscopic cholecystectomy was performed in 26 (89.6%) patients when technical difficulties in isolating the posterior wall of the gallbladder arose. Using the Ultracision ultrasonic scalpel by Ethicon, laparoscopic cholecystectomy was performed in 47 patients with Mirizzi Syndrome Type I. Conclusions: 1. Ultrasonographic diagnosis is an informative method that allows establishing the presence of Mirizzi Syndrome with a high probability at the preoperative stage. 2. Obtaining information about the high probability of Mirizzi Syndrome before surgery allows for proper planning of the possible scope and tactics of operative intervention. 3. Subtotal laparoscopic cholecystectomy expands the possibilities of minimally invasive technologies in the surgical treatment of Mirizzi Syndrome Type I. 4. The use of the ultrasonic scalpel in laparoscopic cholecystectomy in patients with Mirizzi Syndrome Type I enables effective and safe dissection with minimal damage to surrounding tissues, reducing the risk of intra- and postoperative complications.